The National Treatment Purchase Fund (NTPF) is seeking assurances from all hospitals that rules governing the operation of waiting-list initiatives that it funds are being followed.
The move follows concerns raised about special out-patient clinics run on Saturdays in the children’s hospital group, Children’s Health Ireland (CHI).
On Tuesday, the NTPF suspended funding to CHI pending inquiries into issues raised in an internal report, which was originally drawn up in 2021 but never published or circulated to senior figures elsewhere in the health service.
The NTPF said on Tuesday: “Following serious concerns raised over the 2021 CHI report, the NTPF immediately placed a temporary pause on all insourcing work with CHI. It has initiated a comprehensive review of all insourcing work with CHI to gather the necessary assurances regarding compliance, value for money and appropriate use of NTPF funding mechanisms.”
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Minister for Health Jennifer Carroll MacNeill suggested on Wednesday that this NTPF pause on funding would continue for a week or 10 days as it sought assurances on the operation of waiting list initiatives at the group.
It is understood that the NTPF has now sought assurances from all hospitals. The current pause on funding, however, applies only to CHI.
The NTPF will this year receive about €230 million from the exchequer to buy treatment in both the public and private systems for patients on waiting lists.
The NTPF, as part of its work, pays for treatment for those waiting longest to be provided outside core working hours in public hospitals by staff working in their own time.
Hospitals and staff are paid additional sums for taking part in such initiatives. This process is known as “insourcing”.
Insourcing programmes are targeted at the longest waiting public patients.
The internal CHI report said there were “significant concerns about prudent and beneficial management of NTPF funding and a lack of oversight in relation to access schemes that were not in keeping with the memorandum of understanding”.
The report highlighted 179 children seen at five special outpatient clinics operated by a consultant at CHI over five Saturdays. The report questioned whether such clinics were needed and whether there was capacity elsewhere in the public system for the children in question to be seen.
The consultant concerned received €35,800 in additional funding from the NTPF.
In the Dáil on Thursday, Labour Justice spokesman Alan Kelly said CHI should be subsumed into the HSE. This is “about the only outcome that is in any way possible” and “it needs action quick”.
He said: “we need to have confidence in governance and the day-to-day running, because the culture in CHI seems to be absolutely atrocious.”
He also called for the NTPF to be closed down in an orderly manner with a full audit of its operations and who benefited. “I don’t believe that the NTPF is or should be in place in a country where the healthcare system is working,” he said, adding “we should be in a situation where those who need treatment the most are prioritised based on need.
“It shouldn’t be a case of: we can’t deal within the public system, so we’ll actually pay off others to do the work.”
